Pennsylvania Verdicts

Plaintiff(s):

Juan Duque (Male, 20s)

Plaintiff Attorney(s):

Alisa P. Marion;
Beckman & Marion;
Philadelphia,
PA,
for
Juan Duque ■ Bradley T. Beckman;
Beckman & Marion;
Philadelphia,
PA,
for
Juan Duque

Plaintiff Expert(s):

Paul Genecin;
M.D.;
Internal Medicine;
New Haven,
CT called by
Alisa P. Marion ■ David Hopkins;
A.S.A.;
Economics;
King of Prussia,
PA called by
Alisa P. Marion ■ Frank Rybicki;
M.D., Ph.D.;
Radiology;
Boston,
MA called by
Alisa P. Marion ■ Jeffrey Freed;
M.D.;
Surgery;
New York,
NY called by
Alisa P. Marion ■ Kathleen Corrigan;
R.N.;
Life Care Planning;
Havertown,
PA called by
Alisa P. Marion

Defendant(s):

William C. Meyers, M.D., 

Drexel Surgical Associates, 

Core Performance Physicians, 

Drexel University Physicians, 

Hahnemann University Hospital, 

Tenet Healthsystem Hahnemann LLC, 

Tenet Healthsystem Philadelphia Inc., 

Drexel University College of Medicine, 

Philadelphia Health & Education Corp.

Defense Attorney(s):

Timothy I. McCann;
McCann and Geschke;
Philadelphia,
PA,
for
Hahnemann University Hospital, Tenet Healthsystem Hahnemann LLC, Tenet Healthsystem Philadelphia Inc. ■ Heather Hansen;
O’Brien & Ryan, LLP;
Plymouth Meeting,
PA,
for
William C. Meyers, M.D., Drexel Surgical Associates, Core Performance Physicians, Drexel University Physicians, Drexel University College of Medicine, Philadelphia Health & Education Corp.

Defendant Expert(s):

Alan Schuricht;
Surgery;
Philadelphia,
PA called by
Timothy I. McCann ■ Daniel Dempsey;
Surgery;
Philadelphia,
PA called by
Heather Hansen ■ Jonathan Berlin;
Radiology;
Evanston,
IL called by
Timothy I. McCann

In March 2009, plaintiff Juan Duque, in his early 20s, presented to general surgeon William Meyers with complaints of groin pain, in Philadelphia. Meyers diagnosed Duque, a soccer player, with athletic pubalgia, otherwise known as a sports hernia, and said that it would need to be surgically repaired. While performing the surgery, Meyers observed mesh in Duque’s abdomen, placed there during a prior hernia surgery, and Meyers decided to let the mesh remain, fearing a possible bowel perforation if he removed it. Following the procedure, Duque adhered to the postoperative regimen of maintaining normal recovery. About six to eight weeks later, however, Duque continued to complain of pain; he followed up with Meyers, who decided that he would operate again. On Dec. 11, Meyers performed another surgical repair of Duque’s hernia, during which he removed some of the pre-existing surgical mesh. Duque was discharged that day; because he lived in Connecticut, he stayed in a hotel that evening, during which time his pain worsened. On Dec. 12, Duque presented to Hahnemann University Hospital’s emergency room around noon, and he was admitted after it was noted that his white blood-cell count was high. Meyers was contacted about Duque’s condition. According to Duque, the initial resident turned over the case to another resident before leaving for the day and instructed her to order a CT scan. The initial resident apparently did not inform her that bowel perforation was a concern, and so the second resident ordered a CT scan with a barium-sulfate contrast. After waiting for about 10 hours in the hospital, Meyers underwent a CT scan which showed a perforated bowel with spillage of bowel contents and barium throughout his system. Meyers subsequently arrived at the hospital to repair the bowel. Duque claimed that he suffered irrevocable bowel damage which forced him to forego his upcoming career as a professional soccer player. (At the time of the surgery, Duque, a collegiate soccer player, was weeks away from going to Colombia on a contract to play professionally.) Duque sued Meyers and his practice, Core Performance Physicians; Drexel University College of Medicine (Meyers’ employer) and its affiliates; and Hahnemann University Hospital and its affiliates, on claims of medical malpractice. An expert in surgery testified that Duque was a patient at high risk of bowel perforation given his hernia history, and Meyers was aware of this, as evidenced by his decision not to remove the pre-existing mesh during the March surgery. When Meyers performed the second surgery, he should have seen that he had perforated the bowel before he closed Duque’s abdomen, but failed to do so. Had he observed the perforation and immediately repaired it, Duque would not have been subjected to the barium-sulfate contrast the following day, said the expert. Duque’s counsel maintained that a breakdown of communication occurred between Meyers and the residents at the hospital on Dec. 12. Meyers knew that Duque was a high risk for perforation, but he failed to communicate this to the resident he spoke to at Hahnemann University Hospital’s emergency room, and the resident then failed to communicate any urgency or risk to the second resident. Duque’s counsel asserted that the hospital breached the standard of care by administering barium-sulfate contrast to a patient who was at high risk for bowel perforation. An expert in radiology opined that barium is never administered to a patient at risk for perforation or who has recently undergone an abdominal surgery, since the contrast, as it did in the case of Duque, absorbs into the system; from there it wreaks havoc on the body by causing tremendous inflammation and infection, which are difficult to treat. Moreover, the barium-sulfate contrast can remain in a person’s body indefinitely. The expert concluded that, instead of the barium, the hospital should have administered a water-soluble iodinated radiopaque contrast, known as gastrografin. Duque’s counsel further asserted that it should not have taken 10 hours for the bowel perforation to have been observed. Meyers testified that he did not perforate Duque’s bowel while performing the Dec. 11 procedure. An expert in surgery opined that, based on Meyers’ testimony, there were no signs or symptoms of a bowel perforation during the surgery. Before acknowledging that the barium administration was a mistake, the hospital’s expert in surgery testified that the resident acted appropriately under the information that was conveyed to him by Meyers, and that no additional harm resulted from the barium.

Duque remained in the hospital for 18 days, during which time he had another surgery to remove abscesses in his abdomen. Two drains were placed in his back to drain the infected fluid that continued to accumulate around his organs. On Jan. 1, 2010, Duque returned to the hospital for further drainage procedures, and he was released about a week later. (The drains remained inside Duque for several weeks.) Duque continued to treat with antibiotics through February. In late winter, Duque began a course of physical therapy for about three months. During that time, he worked on strength-training, conditioning, and regaining 35 pounds he lost as a result of the infection. Despite extensive rehabilitation, Duque reportedly was unable to regain his core strength, prompting him to relinquish a career in professional soccer. Duque continued regularly to follow up with his physician. An expert in life-care planning opined that Duque is at high risk for a number of complications, including bowel obstruction and perforation, which would require invasive surgeries with extended inpatient care. If Duque were to ever need future abdominal surgery, such as an appendectomy, it would pose as a high risk due to his extensive abdominal scar tissue, according to the expert. An expert in economics calculated varying projections for future medical costs, taking into account interest from 1 percent to 6 percent. One of the amounts the expert presented was approximately $1,800,000. At the time of trial, Duque was living in the Washington, D.C., area and worked at a financial consulting company. Duque claimed that he suffers from abdominal pain (which requires him to lead a sedentary lifestyle), difficulty eating (no large meals; he eats small portions intermittently), and issues with his bowel and bladder (he uses the bathroom more frequently and urgently). He sought to recover unspecified amounts in noneconomic damages for past and future pain and suffering. The defense did not dispute Duque’s injuries and damages.

The jury found that Hahnemann University Hospital was negligent and its negligence was a factual cause of harm to Duque, who was determined to receive $3,345,360. No negligence was found against Meyers.

Juan Duque: $1,550,000 Personal Injury: pain and suffering; $1,795,360 Personal Injury: future medical expenses for 51 years

Judge:

Albert J. Snite Jr.

Demand:

$1,500,000

Offer:

$1,600,000 (made by Hahnemann University Hospital during jury deliberations)

Trial Length:

2
 weeks

Trial Deliberations:

1
 days

Post Trial:

The parties settled, including all post-trial motions, for an undisclosed amount.

This report is based on information that was provided by plaintiff’s counsel. Counsel for Hahnemann University Hospital, Tenet Healthsystem Hahnemann LLC, and Tenet Healthsystem Philadelphia Inc. declined to contribute. Counsel for Meyers, Core Performance Physicians, Drexel Surgical Associates, Drexel University College of Medicine, Drexel University Physicians, and Philadelphia Health & Education Corp. did not respond to the reporter’s phone calls.